Provider Demographics
NPI:1619923372
Name:URMILA BHUVANESH, M.D., LLC
Entity Type:Organization
Organization Name:URMILA BHUVANESH, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:URMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUVANESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-789-3408
Mailing Address - Street 1:200 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5363
Mailing Address - Country:US
Mailing Address - Phone:203-789-3408
Mailing Address - Fax:203-789-3909
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-789-3408
Practice Address - Fax:203-789-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026959174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE64477Medicare UPIN